By Terri McCormick

Lyme disease and other tick-borne illnesses are often discussed in terms of joints, nerves, and immune dysfunction. One critical area is frequently overlooked: the mouth.

That gap was the focus of a recent clinical lecture on oral–systemic health and its relevance to tick‑borne disease, presented by Dr. Alexander Volchonok, a board‑certified periodontist with advanced training in biologic dentistry. He collaborated with Dr. Susan Marra, a physician who treats complex chronic illness, including Lyme disease and co‑infections.

Their central message was clear: oral health extends beyond the teeth and gums. From a whole-body perspective, the mouth plays an active role in immune regulation, inflammation, and systemic signaling. In some patients with tick-borne disease, unresolved oral inflammation may contribute to ongoing immune activation and stalled recovery.

This is especially relevant for the Lyme community, where many patients hit treatment plateaus despite appropriate antimicrobial and supportive care. Identifying hidden sources of persistent inflammation may help explain why progress sometimes slows.

How the mouth connects to the rest of the body

The mouth is a primary gateway between the outside world and the immune system. Microbes, nutrients, toxins, and inflammatory signals pass through the oral cavity and can influence immune activity throughout the body.

The oral cavity hosts one of the body’s most active microbiomes, made up of hundreds of bacterial species along with fungi and viruses. When balanced, this ecosystem helps regulate immune function, support digestion, contribute to healthy blood flow through nitric oxide production, and protect the body’s natural barriers.

The gums are an important part of the body’s defense system. When they’re healthy, they help keep germs and irritants from entering the bloodstream. But if that balance is disrupted, inflammation in the mouth can worsen and send signals that affect the immune system throughout the body.

Oral microbiome dysbiosis and chronic inflammation

Oral disease develops when the microbiome shifts from a healthy balance (symbiosis) to an imbalanced state (dysbiosis). In dysbiosis, protective bacteria decline, harmful species expand, inflammatory biofilms form, and the immune system remains chronically activated.

This shift can be accelerated by factors commonly seen in people with Lyme disease and other complex chronic illnesses, including immune dysregulation, medication effects, reduced saliva flow, nutrient deficiencies, chronic stress, and autonomic dysfunction.

Once dysbiosis takes hold, oral inflammation may become self-sustaining, contributing not only to local problems in the mouth but also adding to the body’s overall inflammatory load.

Periodontal disease as a chronic inflammatory driver

A major focus of the lecture was periodontal disease, an infection-driven inflammatory condition affecting the tissues that support the teeth. It can progress from mild gum inflammation to deep pockets, bone loss, and eventual tooth loss.

Importantly, periodontal disease often advances quietly. Pain is not always present, especially in early or moderate stages. Chronic inflammation at the gum line creates a persistent wound with direct access to the bloodstream, allowing inflammatory mediators and microbial byproducts to influence the body’s wider immune response.

In patients with tick-borne disease, where immune regulation is already impaired, this ongoing inflammatory input may compound symptoms and hinder recovery.

Dental and jawbone pathology that may go unrecognized

The lecture also addressed dental and jawbone problems that may not be immediately apparent during routine dental exams. These include infections associated with teeth that have lost their blood supply (sometimes called necrotic teeth) and areas of impaired bone healing following dental procedures.

One example was jawbone that fails to heal properly after extractions, wisdom tooth removal, or other dental trauma. Reduced blood flow and low oxygen levels in these areas can limit the body’s ability to detect and resolve inflammation.

Because these issues are often silent, patients may have no symptoms even while underlying problems persist and add to the body’s overall immune load.

Why antibiotics alone may not resolve the issue

In tick‑borne disease, some tissue environments are notoriously difficult for systemic treatments to reach. The lecture noted that the oral cavity can share these same challenges—such as biofilm formation, low‑oxygen pockets, and reduced blood flow in diseased areas.

As a result, antimicrobial therapy may reduce symptoms without fully resolving underlying inflammatory drivers if oral disease remains unaddressed. This does not suggest antibiotics are ineffective, but rather that persistent oral inflammation may continue to stimulate immune responses even when systemic treatment is appropriate.

How oral health fits into Lyme disease care

From a whole-body perspective, oral health is not a stand-alone issue. It’s part of an interconnected network involving the immune system, nervous system, vascular system, and inflammatory signaling pathways.

Addressing oral disease is not a replacement for medical treatment of Lyme disease. Instead, it may serve as an important adjunct within an integrated care model, particularly for patients who struggle to make lasting progress despite appropriate treatment.

Why this information matters to the Lyme community

This lecture did not claim that oral disease causes Lyme disease. Rather, it highlighted how unresolved oral inflammation and hidden dental pathology may contribute to ongoing immune activation and complicate recovery in some individuals.

For people living with Lyme disease and associated co-infections, the mouth may be an overlooked source of inflammatory stress. Integrating oral health into a whole-body evaluation may help clinicians and patients identify contributors to illness that would otherwise remain hidden.

The key takeaway is not to assume dental issues are the root of chronic illness, but to recognize that oral health may be an important piece of the puzzle when healing stalls.

About the speakers

This discussion on oral–systemic health and its relevance to tick-borne disease was led by Dr. Alexander Volchonok and Dr. Susan Marra, two clinicians working at the intersection of complex chronic illness and whole-body care.

Dr. Volchonok is a board-certified periodontist with advanced training in biologic dentistry. His clinical work focuses on the relationship between oral health, inflammation, and systemic disease, with particular attention to dental and jawbone conditions that may go unrecognized during routine care. During the presentation, Dr. Marra noted that his combination of specialty training and biologic dentistry expertise is rare in the United States.

Dr. Marra is a physician who treats patients with complex chronic illness, including Lyme disease and associated co-infections. Her work centers on immune dysregulation, chronic inflammation, and integrative care approaches for patients who struggle to achieve sustained improvement.

Terri McCormick is a writer and advocate with LymeDisease.org. She is author of the forthcoming book Being Misdiagnosed: Stories That Reveal the Hidden Epidemic of Lyme Disease.